Healthcare Provider Details

I. General information

NPI: 1245048099
Provider Name (Legal Business Name): ALLISON A LYONS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/26/2024
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5112 WEST TAFT RD. DEPT OF MEDICINE MEDICAL SERVICE GRO SUITE U
LIVERPOOL NY
13088
US

IV. Provider business mailing address

5112 WEST TAFT RD. DEPT OF MEDICINE MEDICAL SERVICE GRO SUITE U
LIVERPOOL NY
13088
US

V. Phone/Fax

Practice location:
  • Phone: 315-701-2171
  • Fax: 315-701-2185
Mailing address:
  • Phone: 315-701-2171
  • Fax: 315-701-2185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number354311
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: